[NurseCherlove]

Originally Posted by ERNurse03

I don't agree with this statement...at least not in this area. I live in southern Ohio, and EMS will respond when called for anything. If you have someone who is suicidal they are deemed a threat to themselves the same way a homicidal person is a threat to others. If the person tells the EMT that he/she is suicidal they must go in for evaluation even if they have to be taken by force. If they do not say that to the EMT then the EMT's cannot "kidnap" them and they have a right to refuse to go. From my many years in the ER, all we need is the chief complaint of "suicidal ideation" and we have 1:1 observation and even restrain the patient if necessary to prevent them from leaving without a thorough psychiatric evaluation. After the evaluation if they are still deemed a threat to themselves they can be admitted under "emergency admission" or "pink slip" or "commitment" whatever they call it where you live. They will then be placed on an Acute Psychiatric inpatient ward...usually a minimum of 72 hr hold...which are locked wards... until they are stabalized on antidepressants or by psychotherapy.
If someone tells you they are suicidal....call EMS immediately! They will respond! Suicidal Ideations is an acute mental illness and requires immediate attention. Acutely suicidal people are not thinking clearly and are not capable of making rational decisions.

Yes. Also, as a health care professional, I can tell you that if they do admit to having suicidal ideations, then the next step is to ask them if they have a plan. I bring this up just because this person may possibly be reluctant to discuss these things with strangers (EMS). Therefore, when you make the call (to EMS or even your local county mental health center), you can tell whoever you talk to that indeed they have a plan, etc.

Then, do not leave this person alone if at all possible. If for some reason you have just got to, initiate a "safety contract" specifically for the length of time you will be gone...i.e. "I (name) promise not to harm myself for the next (30 minutes, hour, 24 hours, whatever). If I should begin to have these thoughts, I promise I will immediately call X." Then have him to sign and date/time it.

You probably didn't need to know quite all of that, but that is technically how you would handle it.

Bless you for your concern about this man. From what you said, I too would be very suspicious of the same thing.

[graduatenurse]

This is how I would handle the situation, but its just me. I would go over to his house and strike a conversation at first just to make him feel comfortable. Then slowly I would bring up the subject about him asking you questions about drug overdose and ask him if he is feeling suicidal. If he says yes, then I would call the suicide hotline and either they can call the EMS or they would want to talk to him and intervene. I would tell him that I care about him and encourage him to get help.

[Ayeloflo]

Originally Posted by luvmy3kids

While I understand the point of asking this question.... it's very possible that they will likely lie and say everything is fine, right? Then what??

Not that you can just assume that they are suicidal without asking, but I don't know how often people admit that they are, or are even aware of their actual intentions and thoughts/feelings.

I don't know what you should do exactly, but I wish you good luck and I hope you can help this friend in which ever way he needs it. Take care.

Jennifer

Thank you all very much for all the pointers. I do agree. I am not a proffessional and it is inappropriate of me to give advice.
I have worked as a 911 tele-interpreter before. So, after hearing part of his problems, I got frightened when he asked me about drug overdose. Not, that I was trying to teach or prescribe meds. But, I just started having a flood of flashback voices from telephone calls I had in EMS in my prior jobs as a tele-interpreter.
I do know that people do intensionally overdose as a method of suicide.
I also did ask him directly if he was depressed, and he denied with a smile. But, based on my little knowledge from nursing school, I knew he was depressed. I have received info for suicide hotline from EMS.
Now, I just have to be tactful about talking with him to get information and to support him.

He has already denied being depressed so obviously I should push it. I really have to be there for him, non-judgemental, supportive and all the good stuff so that he doesn't feel driven away. If he doesn't feel comfortable talking with anyone else about it, he won't talk about it, right?
He heard his footsteps upstairs and his son's voice so I know he is still with us. I'm still praying the keeping the hopes up for something good.

[queenjean]

Jennifer, you would be surprised; many suicidal pts I have worked with are very upfront when you point-blank ask them if they are having thoughts of suicide, and if so, do they have a plan. Not all, of course, but a large number do in fact admit to it when directly confronted.

OP, I have been in your situation recently. I feel I have a strange perspective on suicide as a nurse. I never know if I'm looking for suicidal ideations when in fact someone is just blowing off steam, if I'm reading unintended meaning into certain statements; it's really difficult.

One of my friend's recently broke off a long term relationship. Long story short, he called me asking if I could get him some meds for Wellbutrin. I told him no, he needed a script, and he said he knew that, he just wanted to start them now, he wanted to stop smoking right now, as opposed to waiting to get into the doctor in 5 days.

After I hung up I was like, what? I think I just totally missed the entire point of our conversation--our conversation had felt odd, and then I realized that though he said he wanted to stop smoking, when I suggested some over the counter stuff and some non-antidepressant stuff, he was insistent that he wanted the Wellbutrin, and that he couldn't wait 5 days to get the script from the doc. Which made alarm bells go off in my head.

So I recommend you do what I did. I called the suicide hotline and got some basic info from them. Then I got some info on how to get treatment for depression and therapy. Then I called him back, told him I was coming by, and brought all the info for him. I told him I might be reading too much into his words, but that I had lost a friend to depression and suicide last year, and our conversation earlier that day had made me nervous.

He denied feeling suicidal and said that our conversation was exactly what it was--he just wanted to quit smoking and wanted to quit right now. I still don't believe him--something about his tone and his lack of eye contact, and just some intuition tells me he was lying to me.

So I left it at that, but I also gave him a card with all the info that I had gathered. In the card I also told him how much I cared for him, and let him know he could always call if he needed something.

He never called, I don't know if he quit smoking or got therapy, but I know my message got across. And that's all I could do. I honestly think that there are two kinds of suicidal people. There are those who use suicide as an attention mechanism, to get the help that they need. And there are those who are very intent on suicide and no intervention will stop them. If my friend fell into the first category, the info I gave him and my own interest would have hopefully met his needs or at least pointed him in the right direction. If he fell in the second category, I honestly know nothing I did would have changed anything.

My friend who committed suicide last year was very very sneaky about it. None of us knew he had purchased a gun, he arranged his child care and social life so that he would have 5 days where he would not be disturbed--the first two days spent cataloguing everything in his house. Everything was in boxes with names on it, what was to be given to whom. Then he got all his financial papers in order, so that his exwife and daughter would have no problems with his finances, selling the house, etc. Then he shot himself on the 4th of July, while everyone else was shooting off fireworks--no one noticed the noise. He made sure to ask a friend to come over for supper on the 6th of July--but the note in the envelope on the door told the friend what he had done and to not enter, just call the coroner. So that his daughter wouldn't be the one to find him, but that he would have time to die if he didn't die immediately.

It was so well thought out, and none of us even had ANY idea. It has reinforced my belief that you can only do so much, and then that person has to either want to live or die. You are not responsible for anyone else's actions. Do not carry their burden.

[luvmy3kids]

Originally Posted by queenjean

Jennifer, you would be surprised; many suicidal pts I have worked with are very upfront when you point-blank ask them if they are having thoughts of suicide, and if so, do they have a plan. Not all, of course, but a large number do in fact admit to it when directly confronted.

OP, I have been in your situation recently. I feel I have a strange perspective on suicide as a nurse. I never know if I'm looking for suicidal ideations when in fact someone is just blowing off steam, if I'm reading unintended meaning into certain statements; it's really difficult.

One of my friend's recently broke off a long term relationship. Long story short, he called me asking if I could get him some meds for Wellbutrin. I told him no, he needed a script, and he said he knew that, he just wanted to start them now, he wanted to stop smoking right now, as opposed to waiting to get into the doctor in 5 days.

After I hung up I was like, what? I think I just totally missed the entire point of our conversation--our conversation had felt odd, and then I realized that though he said he wanted to stop smoking, when I suggested some over the counter stuff and some non-antidepressant stuff, he was insistent that he wanted the Wellbutrin, and that he couldn't wait 5 days to get the script from the doc. Which made alarm bells go off in my head.

So I recommend you do what I did. I called the suicide hotline and got some basic info from them. Then I got some info on how to get treatment for depression and therapy. Then I called him back, told him I was coming by, and brought all the info for him. I told him I might be reading too much into his words, but that I had lost a friend to depression and suicide last year, and our conversation earlier that day had made me nervous.

He denied feeling suicidal and said that our conversation was exactly what it was--he just wanted to quit smoking and wanted to quit right now. I still don't believe him--something about his tone and his lack of eye contact, and just some intuition tells me he was lying to me.

So I left it at that, but I also gave him a card with all the info that I had gathered. In the card I also told him how much I cared for him, and let him know he could always call if he needed something.

He never called, I don't know if he quit smoking or got therapy, but I know my message got across. And that's all I could do. I honestly think that there are two kinds of suicidal people. There are those who use suicide as an attention mechanism, to get the help that they need. And there are those who are very intent on suicide and no intervention will stop them. If my friend fell into the first category, the info I gave him and my own interest would have hopefully met his needs or at least pointed him in the right direction. If he fell in the second category, I honestly know nothing I did would have changed anything.

My friend who committed suicide last year was very very sneaky about it. None of us knew he had purchased a gun, he arranged his child care and social life so that he would have 5 days where he would not be disturbed--the first two days spent cataloguing everything in his house. Everything was in boxes with names on it, what was to be given to whom. Then he got all his financial papers in order, so that his exwife and daughter would have no problems with his finances, selling the house, etc. Then he shot himself on the 4th of July, while everyone else was shooting off fireworks--no one noticed the noise. He made sure to ask a friend to come over for supper on the 6th of July--but the note in the envelope on the door told the friend what he had done and to not enter, just call the coroner. So that his daughter wouldn't be the one to find him, but that he would have time to die if he didn't die immediately.

It was so well thought out, and none of us even had ANY idea. It has reinforced my belief that you can only do so much, and then that person has to either want to live or die. You are not responsible for anyone else's actions. Do not carry their burden.

Wow! Thanks for the interesting post. My Aunt's husband commited suicide about 3 years ago. She happens to be an RN too. No one had a clue it was coming.... and I honestly believe it was his "last" way to just do something to make her feel awful. (it worked... btw)

But really, I totally agree with what you said. Most times it is either a way to get the attention that they need, or they are going to do it anyway, no matter what you do.

There is just no way that I can fathom what that feeling must feel like. I pray for anyone who feels that suicide is the answer. And I pray for all of their family members and friends who have to deal with the aftermath.

Queenjean, I'm so sorry you have had to deal with losing a friend. I can't imagine what that must feel like. I had a good friend who took a bottle of tylenol... then immediately told her dad (we were in high school). I'm pretty sure her intentions were more for the attention as she acted out in many other ways as well. We're just thankful that they were able to get her the help she needed. I couldn't imagine if I had lost her. My heart goes out to you.

Ayeloflo, I admire you for your caring heart and concern you have for your friend. I hope it works out for him. Take care...

[NURSEOK5]

I agree call an EMT or suicide prevention hotline, there is a child in the house also, is the child at risk or in harms way if the father is saying he would give the child up for adoption? This person needs help, I wish you luck with this. It is a sad situation.

[classicdame]

do not give advice. Give facts - like resources and phone numbers. Otherwise you will feel responsible for this person's life and mental health. That is too much a burden and you are not trained to do it well anyway. I hope it all turns out well. Do you need to contact child protective services regarding the baby?